In Port Harcourt, evidence-based guidelines for platelet transfusion therapy in neonatal patients are yet to be defined and the prevalence and pattern of neonatal thrombocytopenia has not yet been reported. Methods: Platelet counts of 132 neonatal patients admitted into the special care baby unit (SCBU) at the University of Port Harcourt Teaching Hospital in Nigeria were assessed using the International Committee on Standards in Hematology (ICSH) approved manual procedures for hemocytometry. 6 Study design: This is a cross sectional study carried out on neonates to determine the prevalence and pattern of neonatal thrombocytopenia. Results: The median platelet count of the neonates was 97.0 × 10 9 /L (interquartile range [IQR] 50-152) while the mean age was 61.7 hours (range 1-336 hours). The overall prevalence of neonatal thrombocytopenia was 53.0%. Mild thrombocytopenia (platelet count 51-100 × 10 9 /L) was found in 39.4% of the neonates, 12.1% had moderate thrombocytopenia (platelet count 30-50 × 10 9 /L), while severe thrombocytopenia (platelet count 30 × 10 9 /L) was detected in 1.5% of the neonates. Of these, 84.84% of the cases occurred within 72 hours (early onset). The most common clinical diagnosis among the neonates was severe birth asphyxia (33.3%), followed by neonatal jaundice (19.7%), neonatal sepsis (16.7%), low birth weight (13.6%), anemia and bleeding (6.1%), and other clinical conditions (10.6%). There was no association between clinical diagnosis and thrombocytopenia (Fisher's exact test = 10.643; P = 0.923). Conclusion: There is a high prevalence of early onset neonatal thrombocytopenia cases in this region of Nigeria, the majority of which are mild in nature. There is a need to define a safer lower limit for platelet count and to determine which neonates will benefit from treatment.

Background:There is paucity of epidemiological data on infectious diseases among antenatal mothers in Bayelsa State of the Niger Delta, Nigeria.Aims:The aim of this study was to determine the seroprevalence of the serological markers Human immunodeficiency virus-antibody (HIV-Ab), Hepatitis B surface antigen(HBsAg), Hepatitis C virus antibody(HCV-A)and antibodies to T. pallidum among pregnant women in Yenagoa, Bayelsa State, South–South Nigeria.Settings and Design:This is a cross-sectional study which was carried out in Yenagoa city, the heart of the Niger Delta, Nigeria.Materials and Methods:Human immunodeficiency virus (HIV) antibodies were detected by using “Determine” HIV-1/2 test strip (Abbott Laboratories, Japan); hepatitis B surface antigen (HBsAg), antibodies to hepatitis C virus (anti-HCV) and antibodies to T. pallidum were carried out using ACON rapid test strips (ACON Laboratories, USA). All positive samples for HIV, HBV and HCV were confirmed using the Clinotech diagnostic enzyme-linked immunosorbent assay (ELISA) test kits (Clinotech Laboratories, USA), while all reactive samples to Treponema pallidum antibodies were confirmed by the Treponema pallidum hemagglutination (TPHA) test (Lorne Laboratories Ltd., UK). All test procedures were carried out according to the manufacturers’ instructions.Statistical Analysis Used:The data generated were coded, entered, validated and analyzed using Statistical Package for Social Science (SPSS), version 12.0, and Epi info. The seroprevalence of syphilis, HBsAg, HCV and HIV was expressed for the entire study group by age, sex and other demographic features using Pearson chi-square analysis. Values below 0.05 were considered statistically significant.Results:A total of 1,000 apparently healthy pregnant women aged between 15 and 44 years with a mean of 27.34±5.43 years were screened. In terms of percentage, 89.4% of the subjects were married, and 10.6% were without formal husbands. The overall seroprevalence of HIV, HBsAg, HCV and syphilis was found to be 4.1%, 5.3%, 0.5% and 5.0%, respectively.Conclusions:High prevalence of some infectious diseases was observed in the present study, which may pose serious health risk to women of reproductive age in this region. It is important to point out that there is need to improve antenatal care of pregnant women by mandatory screening for these infectious diseases.

Background:Alloantibodies of clinical importance can cause transfusion reactions or hemolytic disease of the fetus and newborn (HDFN). The frequencies of these antibodies have not been reported in our locality.Aims:To determine the frequency of occurrence of alloantibodies among pregnant women in Port Harcourt, Nigeria.Settings and Design:This is a prospective study, which was carried out in the Braithwaite Memorial Specialist Hospital, Port Harcourt, Nigeria.Materials and Methods:Screening and identification of red blood cell alloantibodies was done on the sera of 500 pregnant women using the DiaMed, DiaCell, and DiaPanel reagents (Cressier, Switzerland). ABO and Rh blood groups were done using antisera bought from Biotec (Ipswich, UK).Results:Alloantibodies were identified in the serum of 17 of the 500 (3.4%) pregnant women. The specificity of the antibodies was as follows: anti-C 6 (1.2%), anti-E 3 (0.6%), anti-Jsb 3 (0.6%), and anti-K 5 (1.0%). No anti-D was identified despite 8.6% of the study population being Rhesus D (Rh D) negative. The distribution of the antibodies was found to be independent of the blood groups of the participants (χ2 = 4.050, P = 0.670). Blood group O constituted the highest percentage (48.0%).Conclusion:This study has identified the presence of non-Rh D antibodies to the proportion of 3.4%. Rh D antibody was absent in this population irrespective of the relatively high percentage of Rh D negative women. There is a need to determine the actual risk these antibodies may pose to the antenatal women and to include antibody screening and identification in routine antenatal care.

BackgroundD-dimer levels have been reported to increase progressively during pregnancy, but how this affects Nigerian women is not well known.ObjectiveThis study aims to determine the D-dimer concentration and its relationship to other coagulation parameters among pregnant women in Port Harcourt, Nigeria.MethodIn a cross-sectional observational study conducted in Port Harcourt, Nigeria, 120 pregnant women and 60 nonpregnant controls, drawn from a tertiary health institution in the Niger Delta, Nigeria, were assessed, using the standard procedures, for the following parameters: D-dimer concentration, prothrombin time, activated partial thromboplastin time, platelet count, hemoglobin, and packed cell volume.ResultsThe median D-dimer concentration of 153.1 ng/mL in the pregnant group was found to be significantly elevated when compared with the control value of 118.5 ng/mL (t = 2.348, P = 0.021). Conversely, there was a marked depression in the platelet count among pregnant women (193.5 × 109/L) when compared with 229.0 × 109/L in the control group (t = 3.424; P = 0.001). There was no statistically significant difference in the values for the prothrombin time and the activated partial thromboplastin time between pregnant and nonpregnant women. D-dimer values correlated positively and significantly with gestation (r = 0.36; P < 0.01) and negatively with international normalized ratio values (r = −0.281; P < 0.05). About 63.3% of the pregnant women had normal D-dimer values (0–200 ng/mL), 26.7% of the pregnant women had elevated D-dimer levels (201–499 ng/mL), while 10.0% of the pregnant women were found to be at risk of thrombosis (D-dimer > 500 ng/mL). A linear relationship was found to exist between D-dimer and gestation (y = 8.355x + 36.55; R2 = 0.130; P < 0.005).Conclusion10% of the pregnant women in this population had elevated D-dimer levels over 500 ng/mL, and through comparison with what has been reported in the literature, there is the possibility that this group may be at risk of thrombosis. Further studies, incorporating other diagnostic parameters, may be needed before a more logical conclusion can be drawn, since the D-dimer is not a specific test.

Background: This study aimed to determine the frequency of rare blood group antigens among pregnant women in Port Harcourt Metropolis. Methods:The frequencies of Rh antigens and phenotypes of the pregnant women in Port Harcourt Metropolis, Nigeria, were determined, using standard serologic techniques.Results: Of the 374 pregnant women studied, the frequencies of the Rh antigens within the population were D (89.0%), c (82.0%), e (54.0%), C (24.3%), E (20.1%). The frequencies of the Rh antithetical antigens were DD/Dd (91.2 %), Cc (19,5%), cc (84.5%), Ee (13.9%), ee (54.3%), CC (25.1%), EE (19.8%) and dd (10.4%). Seven (1.9%) were found to be Rh null , sixteen(4.3%) were found to be D--or exalted D. Phenotypes without RhD reactivity were -c-(2.9%), -Cc (0.3%), -C-(0.3%), -Ee (0.5%) and -E-(0.3%). The most frequently occurring Rh phenotype was Dccee with a frequency of (25.8%). RhD-ve was found to be significantly associated with HDN outcome ( 2=6.605 and P=0.01). Conclusion:We concluded that: 1) There is the presence of uncommon Rh phenotypes in our population. 2) Rh null exists in this study population of which similar studies have not been reported in Nigeria. 3) There is need to conduct studies in other parts of Nigeria in order to compare the frequencies of these rare blood groups in Nigerian population. 4) Molecular studies to establish reasons for deletion and Rh null phenotypes among Nigerian and Africans in general are hereby advocated.